NCT03861494

Brief Summary

This a single blind randomized control study comparing standard of care for nursing hospital discharge education versus same with an additional experimental enhanced educational intervention. It is planned that 300 patients will be enrolled in the study. There are two initial groups: the enhanced stroke education vs usual stroke education.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
21

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started May 2019

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

February 26, 2019

Completed
6 days until next milestone

First Posted

Study publicly available on registry

March 4, 2019

Completed
2 months until next milestone

Study Start

First participant enrolled

May 6, 2019

Completed
2.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 14, 2021

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

September 14, 2021

Completed
Last Updated

December 12, 2023

Status Verified

December 1, 2023

Enrollment Period

2.4 years

First QC Date

February 26, 2019

Last Update Submit

December 5, 2023

Conditions

Outcome Measures

Primary Outcomes (4)

  • Change in score of Stroke Knowledge Questionnaire

    2.1.1 We will measure participant retention of in-hospital stroke education using a Stroke Knowledge Questionnaire. The questionnaire consists of 17 items. Scores range from 1-17. The questionnaire is based on the American Heart Association Stroke Knowledge Questionnaire. The questionnaire is administered during incident hospitalization for stroke (baseline score) and repeated at the 1 month post discharge appointment. The baseline score is subtracted from the 1 month appointment score and the result reflects improvement or worsening performance. The two groups are compared with respect to this difference between baseline pre-stroke education score (number correct) and 1 month post discharge score. Greater positive difference between pre-test and 1 month test reflect improved performance.

    30 days

  • Change in hospital readmission rate

    2.1.2 We will measure the hospital readmission rate at 30 days and compare readmission rates between the two groups of usual education and enhanced education. Lower readmission rates is considered optimal.

    30 days

  • Change in score of Stroke Knowledge Questionnaire

    2.1.1 We will measure participant retention of in-hospital stroke education using a Stroke Knowledge Questionnaire. The questionnaire consists of 17 items. Scores range from 1-17. The questionnaire is based on the American Heart Association Stroke Knowledge Questionnaire. The questionnaire is administered during the incident hospitalization for stroke (baseline score) and repeated at the 6 month post discharge appointment. The baseline score is subtracted from the 6 month appointment score and the result reflects improvement or worsening performance. The two groups are compared with respect to this difference between baseline pre-stroke education score (number correct) and 6 month post discharge score. Greater positive difference between pre-test and 6 month test reflect improved performance.

    180 days

  • Change in hospital readmission rate

    We will measure the readmission rate at 180 days and compare readmission rates between the two groups of usual education and enhanced education. Lower readmission rates is considered optimal.

    180 days

Secondary Outcomes (12)

  • Change in Brief Health Literacy Screen

    30 days

  • Change in systolic blood pressure

    30 days

  • Change in Modified Rankin Score

    30 days

  • Change in Barthel Index

    30 days

  • Change in Brief Health Literacy Screen

    180 days

  • +7 more secondary outcomes

Study Arms (2)

Enhanced Stroke Education

OTHER

This group of participants will receive enhanced education provided by the Stroke Coordinator at the time of discharge. The enhanced education session will last 30 minutes with the participant.

Behavioral: Enhanced Stroke Education

Usual Stroke Education

OTHER

This group of participants will receive the usual stroke education provided by the usual Neuroscience Registered Nurse throughout the hospitalization and at the time of discharge.

Behavioral: Usual Stroke Education

Interventions

In addition to the general stroke education materials and verbal education, the enhanced stroke education group will receive a personalized verbal and written information addressing the patient's specific risk factors including their current status and goals, laboratory values and goals, and current blood pressure and goal. Specific stroke type and etiology is discussed, medication including indication, dose, frequency, physical activity goals, smoking cessation resources, appropriate diet, stroke signs and symptoms and best practice if one sees a stroke (BE-FAST), phone number to call for non-urgent questions, and education over the importance of keeping follow up appointments including Stroke Clinic. Verbal feedback of key points is encouraged.

Enhanced Stroke Education

The usual stroke education group will receive general stroke education including written and verbal information about signs and symptoms of stroke, best practice to engage medical treatment if stroke occurs, general information about heart healthy diet and need for daily physical activity as well as need for compliance with medication recommendations. The education is incorporated with routine patient care and as allowed during quiet times. On the day of discharge, the patient will receive written materials reviewing stroke symptoms, risk factors, heart healthy diet and follow up appointments. The patient will receive written and verbal information about medications including indication, dose, frequency, physical activity goal, smoking cessation resources, appropriate diet, stroke signs and symptoms and best practice if one sees a stroke (BE-FAST), phone number to call for non-urgent questions, the importance of keeping follow up appointments including Stroke Clinic.

Usual Stroke Education

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • patients hospitalized with primary diagnosis of acute or subacute ischemic cerebral infarction
  • years of age or older
  • English speaking
  • admitted to hospital Sunday through Thursday
  • patient or responsible primary caregiver able to understand and provide informed consent
  • prognosis for survival greater than 6 months
  • one or more vascular risk factors (HTN, DLP, current smoker, DM, obesity)
  • live in NWA area (Benton, Boone, Carroll, Madison, and Washington counties),
  • have a working phone.

You may not qualify if:

  • admitted with transient ischemic attack
  • admitted with an intracerebral hemorrhage
  • experience an in-hospital ischemic cerebral infarction
  • hospital to hospital transfer patients
  • nursing home as primary residence before or after discharge
  • hospice
  • inability to comply with post discharge follow up

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Washington Regional Medical Center

Fayetteville, Arkansas, 72703, United States

Location

MeSH Terms

Conditions

Ischemic Stroke

Condition Hierarchy (Ancestors)

StrokeCerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesVascular DiseasesCardiovascular Diseases

Study Officials

  • Margaret Tremwel, MD

    Washington Regional Medical Center

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
CARE PROVIDER
Masking Details
The who Advanced Practice Registered Nurse performing the outpatient follow up visits at one and six months will remain blinded to the enrollment of each participant.
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Stroke Program Medical Director

Study Record Dates

First Submitted

February 26, 2019

First Posted

March 4, 2019

Study Start

May 6, 2019

Primary Completion

September 14, 2021

Study Completion

September 14, 2021

Last Updated

December 12, 2023

Record last verified: 2023-12

Data Sharing

IPD Sharing
Will not share

Locations